Sagging and marionette lines in lower face. What are my options? (photos)

Thank you for your question and photos. You may benefit from dermal fillers as well as a PDO thread lift. Injectable fillers are often used to reduce the appearance of marionette lines and provide powerful, yet subtle anti-aging results.

A PDO thread lift is an excellent choice for addressing skin laxity and early jowl formation. This non-surgical option uses dissolvable sutures to lift tissue and tighten the skin to produce a natural, youthful-looking appearance. I recommend scheduling an in-person consultation with an experienced injector who can help you choose the best approach for your desired results.

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Thank you for your enquiry and sharing your photographs.

I feel that your med spa advice was very sensible. Adding volume around the marionette lines unfortunately will make surgical corrections more difficult.

In terms of escalating treatment levels you could consider:

- Minimal intervention treatments like threads

- A minimal access facelift .

- A formal short scar facelift procedure is the most powerful to affect changes for the area of concern to you. It seems however a bit excessive for your age and the magnitude of the problem.

Thank you for your question. After examining your pictures I believe that all you need is what I call an Uppermini facelift, which is a small incision from the top of the ear up and the hairline lifting your cheeks and jowls also. This will do a great job tightening your face. I also believe that mid face filler deep to the bone which we consider a Y lift would also be helpful. Thank you , Dr. Eric Seiger

I think you are too young to have facelift although there are plenty of surgeons who would be willing to perform a facelift on you at your current age. I don’t think it’s wrong to have a facelift but I would turn you down based on your age.

Hello;-)With over 10 years experience, V.LIF has a reputation for excellence in Korea.We do not perform all the plastic surgeries at V.LIF.We are face&neck lift specialized plastic surgery clinic.Our surgeons dedicated soley to only lifting field. So they have high knowledge and experience with lifting surgeries.
We totally understand your concern through the pictures!As you age your bone shrinks and also due to gravity your skin and SMAS layer sags and it creates jowls and marionette lines.To solve this problem you need some facelift to elevate your skin and SMAS layer.
Since you are young and sagging is not that serious like aged people, perhaps can considermini facelift.
First, V.LIF's Mini Facelift means lifting partial part of your face considering individual condition.We devide face into 3 parts.
1. Mid face2. Lower face3. Double Chin+Jawline.
Depending on your face condition(How much your skin is sagging and loose), we recommend how many parts you will need to elevate.
Mini facelift at V.LIF is not a short lasting facelift elevating just your skin layer with minimal incision which is performed at other clinics.It's not a mini facelift with minimal incision which is performed at other clinics.V.LIF's Mini Facelift is a long lasting surgery which lasts more than 5years-10years(depending on the scope)
We dissect wide range of SMAS layer and cut off retaining ligaments which is essential and excise saggy skin

Dear Brianna,
There are several concerns in play here. One of which is that you seem to have an obsessive focus on what you are seeing. I (we) see a beautiful, young woman in the photos. There is a condition known as Body Dysmorphic Disorder, BDD, that is not uncommon amongst young plastic surgery patients. There is a very simple screening questionnaire that you can self administer to see if you may have elements of it. I am only able to consider this because we don't have your pre-fat transfer photos, or information on when that procedure occurred. It does appear that there could be overcorrection of your nasolabial fold contributing to the appearance of marionette lines. If this is indeed the case, then forget the BDD concept and return to your plastic surgeon for a candid comparison of your before and after fat transfer photos. He or she can give some guidance from there. Good luck!